| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA AND ASSOCIATES | 236 PONTE VEDRA PARK DR PONTE VEDRA BEACH, FL 32082 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $94K | $94K | 5.33% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA AND ASSOCIATES | 236 PONTE VEDRA PARK DR PONTE VEDRA BEACH, FL 32082 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $2K | $2K | 0.09% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA AND ASSOCIATES, LLC | 236 PONTE VEDRA PARK DRIVE STE 101 PONTE VEDRA BEACH, FL 32082 | UNION SECURITY INSURANCE COMPANY | $33K | $11K | $44K | 16.12% |
| MONTOYA AND ASSOCIATES LLC3 Filed as: MONTOYA & ASSOCIATES | 236 PONTE VEDRA PARK DRIVE PONTE VEDRA BEACH, FL 32082 | COLONIAL LIFE | $19K | $1K | $21K | 14.40% |
| ANNALIESE CLARK3 | 1336 HIDEAWAY DRIVE S SAINT JOHNS, FL 32259 | COLONIAL LIFE | $4K | $376 | $5K | 3.30% |
| ALICIA MARCUM3 | 1122 GRAND STREET APT 505 HOBOKEN, NJ 07030 | COLONIAL LIFE | $2K | $385 | $3K | 2.00% |
| TANYA MIRIAM KAKON3 Filed as: TANYA MARIE CALZONE AMOYAL | 101-3 VILLA DEL MAR DRIVE #G PONTE VEDRA, FL 32082 | COLONIAL LIFE | $2K | $309 | $2K | 1.74% |
| NORTH FLORIDA BROKER SOLUTIONS LLC3 Filed as: NORTH FLORIDA BROKER SOLUTIONS | 2134 GRASSY BASIN COURT JACKSONVILLE, FL 32224 | COLONIAL LIFE | $1K | $686 | $2K | 1.26% |
| HOWARD HOROWITZ3 | 2610 ALCOTT STREET CARMEL, IN 46032 | COLONIAL LIFE | $1K | $406 | $2K | 1.16% |
| DOROTHY RING3 | 8300 PLAZA GATE LANE JACKSONVILLE, FL 32217 | COLONIAL LIFE | $1K | $133 | $1K | 0.97% |
| MITCHELL HECTOR MORALES3 | P.O. BOX 2532 NORCROSS, GA 30091 | COLONIAL LIFE | $670 | $147 | $817 | 0.57% |
| JENNIFER ROSE SMITH3 | 4920 W. SAN RAFAEL STREET TAMPA, FL 33629 | COLONIAL LIFE | $624 | $133 | $757 | 0.53% |
| ALYSON MARIE MCMAHON3 | 2127 GRASSY BASIN CT JACKSONVILLE, FL 32224 | COLONIAL LIFE | $334 | $119 | $453 | 0.32% |
| PNC FINANCIAL ENTERPRISES INC3 | 1841 N SHERRY DRIVE ATLANTIC BEACH, FL 32233 | COLONIAL LIFE | $350 | $0 | $350 | 0.25% |
| JAMES M EANES3 | 1700 E JACKSON STREET PENSACOLA, FL 32501 | COLONIAL LIFE | $194 | $112 | $306 | 0.21% |
| ALLYN INCORPORATED3 | 3013 BROOKFIELD LANE CLEARWATER, FM 33761 | COLONIAL LIFE | $233 | $21 | $254 | 0.18% |
| B V STONE INC3 Filed as: BV STONE INC | 1800 SUNSET HARBOUR POINTE LAWRENCEVILLE, GA 30043 | COLONIAL LIFE | $224 | $29 | $253 | 0.18% |
| VB SOLUTIONS LLC3 | 7111 NE 222ND STREET MELROSE, FL 32666 | COLONIAL LIFE | $223 | $0 | $223 | 0.16% |
| PARRISH J PEACHEE3 | 201 W 103RD STREET INDIANAPOLIS, IN 46290 | COLONIAL LIFE | $144 | $32 | $176 | 0.12% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE | $126 | $2 | $128 | 0.09% |
| KLD INSURANCE BENEFITS INC3 Filed as: KLD INSURANCE BENEFITS | 9085 BETHEL ROAD GAINESVILLE, GA 30506 | COLONIAL LIFE | $45 | $54 | $99 | 0.07% |
| PATRICIA DUNCAN3 | 2409 VIA DEL RAY FERNANDINA BEACH, FL 32034 | COLONIAL LIFE | $90 | $0 | $90 | 0.06% |
| NORMAC SOLUTIONS INC3 Filed as: NORMAC SOLUTIONS, INC | 3730 EVEREST DRIVE MONTGOMERY, AL 36106 | COLONIAL LIFE | $45 | $24 | $69 | 0.05% |
| ARIADNE DE BASABE-MACHICHE3 | 1102 NIMROD CIRCLE CORONA, CA 92880 | COLONIAL LIFE | $35 | $14 | $49 | 0.03% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE | $11 | $27 | $38 | 0.03% |
| ROBERT H STONE SR3 | 2900 CAHABA ROAD BIRMINGHAM, AL 35223 | COLONIAL LIFE | $23 | $13 | $36 | 0.03% |
| KLINGBEIL AND ASSOCIATES INC3 Filed as: KLINGBEIL AND ASSOCIATES, INC | 6000 LAKE FOREST DRIVE ATLANTA, GA 30328 | COLONIAL LIFE | $15 | $18 | $33 | 0.02% |
| WAYNE RIMMER3 | 7454 FARMERS RD PENSACOLA, FL 32526 | COLONIAL LIFE | $26 | $1 | $27 | 0.02% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS | 5655 OAKHURST DRIVE SEMINOLE, FL 33772 | COLONIAL LIFE | $8 | $4 | $12 | 0.01% |
| TIMOTHY J REED3 | 21 AZALEA DRIVE LUMBERTON, NJ 08048 | COLONIAL LIFE | $10 | $0 | $10 | 0.01% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTO MARGARITA, CA 92688 | COLONIAL LIFE | $5 | $2 | $7 | 0.00% |
| TODD BOOZER3 | 2900 CAHABA ROAD BIRMINGHAM, AL 35223 | COLONIAL LIFE | $3 | $3 | $6 | 0.00% |
| AIMEE STONE3 | 2317 GARLAND DRIVE BIRMINGHAM, AL 35216 | COLONIAL LIFE | $3 | $2 | $5 | 0.00% |
| TERESA R MASK3 | 12341 YELLOW BLUFF ROAD JACKSONVILLE, FL 32226 | COLONIAL LIFE | $4 | $0 | $4 | 0.00% |
| ROBERT E ELLIS3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE | $1 | $1 | $2 | 0.00% |
| ELAINE S TURNER3 | 94033 DUCK LAKE DRIVE FERNANDINA BEACH, FL 32034 | COLONIAL LIFE | $2 | $0 | $2 | 0.00% |
| RANDALL HALLMAN3 | 2632 LOOPRIDGE DRIVE ORANGE PARK, FL 32065 | COLONIAL LIFE | $2 | $0 | $2 | 0.00% |
| NELSON BENEFITS GROUP LLC3 | 541729 LEM TURNER ROAD CALLAHAN, FL 32011 | COLONIAL LIFE | $0 | $1 | $1 | 0.00% |
| S & B INSURANCE SOLUTIONS LLC3 Filed as: S & B INSURANCE SOLUTIONS, LLC | 54210 SHERWOOD ROAD CALLAHAN, FL 32011 | COLONIAL LIFE | $0 | $0 | $0 | 0.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 218 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 403 | $1.8M |
| Dental | UNION SECURITY INSURANCE COMPANY | 218 | $274K |
| Vision | UNION SECURITY INSURANCE COMPANY | 218 | $274K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 218 | $274K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 218 | $274K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 218 | $274K |
| Prescription drug | UNITED HEALTHCARE INSURANCE COMPANY | 403 | $1.8M |
| Other(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 218 | $416K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 403 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.